Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Int J Health Policy Manag. 2022 Dec 6;11(11):2514-2524. doi: 10.34172/ijhpm.2021.177. Epub 2021 Dec 28.
Philanthropic activities play an important role in health systems. Donors contribute to financing, generating resources, and providing healthcare services in Iranian health system. However, they face many challenges. This study aimed to identify barriers to donors' participation in the Iranian health system and to provide solutions.
This qualitative study was performed using semi-structured interviews with 38 donors and 26 policy-makers and managers in the social affairs department of health ministry and medical universities in 2018. In addition, document analysis was performed and the relevant data were extracted. Thematic analysis was used for data analysis. All ethical considerations were followed in this research.
Insufficient structures, poor communications, low trust, ineffective working processes, bureaucracy, insufficient senior managers' support, weak legal support and poor monitoring were the most important challenges for donors' participation in the Iranian health system. Effective donor participation in the health system requires the creation of an appropriate system including the right structures, processes, culture, and management. The necessary changes must be planned, led and monitored to promote donors' participation in healthcare. A conceptual model was developed to strengthen donors' participation in the health system.
Iranian donors face structural, procedural, cultural, and managerial challenges when financing the health system, generating resources, and providing health services. Policy-makers and managers should tackle these challenges and adopt strategies to reinforce donors' participation in the health system. Planning, organizing, leading, monitoring, evaluation, transparency, accountability, and a commitment to meet donors' needs are necessary for successful philanthropy initiatives in the health sector.
慈善活动在卫生系统中发挥着重要作用。在伊朗卫生系统中，捐赠者为融资、资源生成和医疗保健服务做出了贡献。然而，他们面临着许多挑战。本研究旨在确定阻碍捐赠者参与伊朗卫生系统的因素，并提供解决方案。
本定性研究于 2018 年采用半结构式访谈的形式，对 38 名捐赠者和 26 名卫生部社会事务部门和医科大学的政策制定者和管理者进行了研究。此外，还进行了文件分析并提取了相关数据。采用主题分析进行数据分析。本研究遵循了所有伦理考虑。
结构不足、沟通不畅、信任度低、工作流程效率低下、官僚主义、高级管理人员支持不足、法律支持薄弱以及监测不力是捐赠者参与伊朗卫生系统的最大挑战。为了有效促进捐赠者参与卫生系统，需要创建一个包括适当结构、流程、文化和管理的适当系统。必须规划、领导和监测必要的变革，以促进捐赠者参与医疗保健。已经制定了一个概念模型，以加强捐赠者对卫生系统的参与。
在为卫生系统提供资金、生成资源和提供卫生服务方面，伊朗的捐赠者面临着结构性、程序性、文化性和管理性挑战。政策制定者和管理者应应对这些挑战，并采取策略加强捐赠者对卫生系统的参与。规划、组织、领导、监测、评估、透明度、问责制和承诺满足捐赠者的需求是卫生部门成功开展慈善活动的必要条件。
